INVESTIGATING THE SAFETY AND EFFICACY OF IV FENTANYL FOR BROWN FAT MITIGATION IN ¹⁸FDG‐PET/CT IN PEDIATRIC ONCOLOGY: A MULTI‐INSTITUTIONAL EXPERIENCE

Background: Brown fat is a metabolically active tissue which can take up the 18FDG tracer used in PET/CT scans, potentially leading to diagnostic uncertainty. Metabolically brown more prevalent children than adults with recent studies demonstrating an incidence of uptake 34%–40% cancer. The resultant uncertainty impact clinicians’ ability interpret scans pediatric oncology patients and has potential result unnecessary invasive procedures, upstaged risk stratification, or additional therapy. A lack clinical consensus remains regarding safest most effective method for suppressing 18FDG. Objective: We report first multi-institutional analysis use fentanyl mitigate receiving focus on safety patients. Methods: This multi-institutional, retrospective review (aged >1 year <25 years) undergoing 18FDG-PET/CT following pretreatment from April 2021 January 2023. Scans were conducted per institutional treatment regimens. Patients received weight based dose 10 min prior injection. Vital signs, outcomes, presence was recorded. Similar data recorded who underwent without premedication during this same time period serve as control group. Results: Seventy completed pre-treatment. evenly split by sex (n = 34, 49% male) median age 15 (range 3 y–23 y). Eleven (16%) had common cervical 9, 82%) supraclavicular 82%), intercostal 2, 18%) pararenal 4, 36%) areas. There no adverse events including zero incidents bradycardia, hypoxia, hypotension pretreated cohort. Conclusion: Fentanyl, mitigation patients, well tolerated any events. observed pre-medication higher previously reported literature (16% vs. 6.7%) but lower baseline 34%–40%). Larger, prospective, trials are warranted further explore efficacy Keyword: PET-CT No conflicts interests pertinent abstract.